Registration Form
Health Symposium with Lunch Thursday, October 16, 2008 8:00 a.m. - 2:00 p.m. Registration 8:00 a.m. Program 9:00 a.m. - 2:00 p.m. Charlotte Convention Center
Tables of 10: $650 Tickets: $45 per person
Call The Main Event to Reserve Tickets 704-332-5819 or submit the form below.
Please provide the following contact information:
Contact Name Organization Address City State Zip Code Phone Fax E-mail I will pay by: I will pay online Check
Contact Name
Organization
Address
City
State
Zip Code
Phone
Fax
E-mail
I will pay by:
Individual tickets at $45 per person. How many tickets are you purchasing?
Table of 10 at $650 (per table). How many tables are you purchasing?
I also wish to give an additional gift of
After you click submit, you will be taken to a payment page to make your secure online payment.
If you are mailing a check, please fill out this form, print it and mail it with your check to: CACHE P.O. BOX 31573 CHARLOTTE, N.C. 28231-1573
If you would like more information on becoming a sponsor for this event: Phone 704-332-5819
Carolinas Association for Community Health Equity, Inc. PO Box 31573, Charlotte, NC 28231-1573 704.405.5600 Phone | 704.405.5601 Fax Email Us | Privacy Policy Website By: EyeBenders